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    Old 12-13-2003, 01:37 PM   #1
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    Re: How do you take cortef - I just started

    Originally Posted by Chrisgj
    As you have probably seen in my previous posts, I just started taking cortef. My doctor has never dealt with Primary or secondary, so I don't really trust him to know what to do. Please let me know how you take it and if it helping.
    Chris in St. Louis
    Sorry...when you said "primary or secondary", I'm not sure what you meant. I take it you have Addison's disease since you're posting on this forum. Do you know how you got Addison's? Was it through autoimmune adrenalitis? Solucortef, as you know, is basically cortisol something that your adrenals secrete in response to stress and some other physiological situations (when you need a higher level of sugar in your blood). Its dosing all depends on the can get from 20-240mg by mouth three to four times a day depending on how you respond to it. There is a fine balance with solucortef because your body DOES need it, but if you have too much of it, it's like having Cushing's disease. Your progress can be monitored in terms of your blood sugars and your blood pressure, and also things like urine sodium.

    Last edited by butterflytrans; 12-13-2003 at 01:38 PM.

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    Old 12-16-2003, 08:03 PM   #2
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    Re: How do you take cortef - I just started

    Chris: I think you need another doctor! There is no one way to take Cortef, and it has to be individualized to your treatment. Most people take it in two or three doses over a day, usually not taking the last dose after late afternoon, because it can interfere with sleep otherwise. Did your doctor just prescribe Cortef without any instructions? Sounds to me like you need a good endocrinologist who is experienced with pituitary issues. If you have adrenal insufficiency because of your pituitary injury, you would have secondary Addison's, but you really need someone who knows how to treat it. Do you have other pituitary issues also, such as thyroid, growth hormone, or other hormone deficiencies? There are tests for all of these things. I certainly would go looking for a more experienced doctor. If you have AI, you are going to need one. Good luck.

    Old 12-17-2003, 06:53 AM   #3
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    Re: How do you take cortef - I just started

    Many people do not have doctors that have much experience at first with Addisons. Or whatever the new words are. I have had it for 28 years. There are many ways to take the meds and many meds to take. If cortef is not working for you then you may need to try a different steroid. I take dexamethesone now but I took cortef for 17 years. Cortef must be divided and some prefer two doses and some prefer three. Some people set their clocks ahead one hour before rising in the morning and that really helps them get going in the morning. I personally took mine when I got up at about 6:30 and then I would not take it again until about 4 pm. I was a kid at the time and this stopped working when I was 19. I do have friends though who are addisonians and they take thier meds, upon waking (6-7 am) and then again around noon. Those that divide their doses into three take upon waking (6-7 am) (largest dose of 15-20 mgs) and then bout 2-3 pm (about 10 mgs) and again at betime taking no more than 5 mgs. I personally had a problem sleeping if I take anything after 4 pm now a days. If you are extremlely active then you may need a longer acting steroid like pred, dex, or medrol. I cannot take the HC or cortef anymore because I burn through it too fast and when I wake up in the morning there is not enough to get me going. Dex gives me a slow steady release of meds and I am evenly keeled on it. It is a individual matter. Now it does bouther me that the doc wants to start you so low. Many are in very bad shape when they first start their meds that they should be on stress doses. A stress dose is double your normal perscribed dose. 10 mgs is nothing in the way of meds. The normal replacement dose is 25-35 mgs per day. I would go over that point with him. I am not a doctor and no one here should question you doctors capabilities but you if necessary and I understand that a doctor willing to learn is a wonderful thing. But you need to educate yourself to the best of your ability and always stay informed of your disease. PS You probobly should not be taking so much DHEA. I am on the high end of what a person needs in DHEA and I normally take about 300 mgs of it and I have no adrenals at all. Many of my addisonian friends take no more than 50 mgs of DHEA and they all think my doc is crazy to perscribe me to take so much. But I trust him and he has many addisons patients. Just a thought. Did he tell you to take that much and has he based that on your labs? I know it helps and I would not willingly go without it for a very good reason. So if once your settled on your Cortef if you still need that much then go for it. There are many forums for Addisons and I belong to several so I highly reccomend for you to look around and visit them all and lean as much as possible. Heather W.

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